The proposed study will facilitate improvements in the quality of health care in the U.S. by developing products that are national standards for collecting information about reporting, and evaluating patient experiences with care. Specific project aims are: 1) develop and test ways that organizations can use CAHPS data for quality improvement;2) evaluate strategies for reporting CAHPS results to consumers, patients, and other audiences;3) refine existing CAHPS instruments and develop some new targeted surveys;and 4) disseminate and promote the use of CAHPS products. To accomplish the first aim, the existing literature will be reviewed, to inform an evaluation of pay-for-performance initiatives and interventions targeted at improving care delivered by primary care and specialty providers to patients in the commercial and Medicaid sectors. Pursuing the second aim will entail reviewing and summarizing existing research on reporting quality information, assessing consumer needs for such information, evaluating the CAHPS report card compendium and the talking quality website, constructing and testing composite labels for new surveys, testing reports for culturally diverse audiences (including Spanish language) and those with diminished visual capacity, identify effective strategies for reporting quality information, and developing resources to assist sponsors in developing reports. The third objective will be achieved by conducting cognitive interviews, semi-structured interviews and field tests in order to complete development of the persons-with-mobility-impairment survey, the assisted-living survey, and the health information technology survey. In addition, research will be conducted on cultural comparability of survey responses and the use of non-standard survey data collection methods. The fourth aim will require the development of CAHPS products with the SUN contractor and groups critical to the adoption of CAHPS products, presenting information about CAHPS at professional meetings, and publishing articles in the peer reviewed literature. Accomplishing these objectives will advance the AHRQ CAHPS mission of improving health care by ongoing measurement and reporting of patients'experiences with care. The project team is particularly well suited to achieving the aims of the study based on its extensive prior experience and existing working relationships established in earlier CAHPS work.